Individual provider Active NPI

Reid Blaylock

  • Certified Registered Nurse Anesthetist
  • North Little Rock, AR
National Provider Identifier
1801636485
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148818 Issued in TN
Practice address
3333 Springhill Dr
North Little Rock, AR 72117-2922
Phone
(501) 202-3000
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 148818 TN Primary

Addresses

Primary practice location

3333 Springhill Dr
North Little Rock, AR 72117-2922

Mailing address

224 Copper Way
Little Rock, AR 72223-4038

Other practice location 1

11001 Executive Center Dr
Little Rock, AR 72211-4316
Phone (501) 812-7587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701003211 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416491477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 202-2093

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148818TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jul 1, 2024 Accepting new patients
Arkansas Health Group CurrentSince Jul 1, 2024 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

3333 Springhill Dr
Ste A
North Little Rock, AR 72117

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1801636485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 COPPER WAY",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SPRINGHILL DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172922",
            "telephone_number": "501-202-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11001 Executive Center Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722114316",
            "country_code": "US",
            "telephone_number": "501-812-7587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "REID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "148818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.